Changes in the toilet training of children during the last 60 years: the cause of an increase in tower urinary tract dysfunction?

Objective To analyse the changes in toilet training of children in Belgium in the last three generations and to seek a possible cause for the apparent increase in lower urinary tract dysfunction oner that period. Patients and methods A questionnaire (25 questions) was developed and compl eted by 321 people who had toilet-trained 812 children, The population was divided into three groups according to the age of those who trained the chi ldren. Results There has been a major change in toilet training in the last 60 yea rs; the age at which toilet training began has been significantly postponed . One reason for starting training, i.e, bladder control during the afterno on nap (which can probably be considered as an indication of sufficient bla dder capacity) has become less important. Season (summer) has become a more important factor, as has starting school, Training by bladder drill, forme rly widely used, was progressively abandoned and a more liberal attitude ad opted by the youngest parents. Conclusion There seems to be good concordance between the programmes curren tly proposed for treating bladder dysfunction in children and the tradition al bladder-training methods used by parents 60 years ago. To start bladder training when the child stays dry during the afternoon nap and using bladde r drill might help to avoid permanent bladder dysfunction. The lack of form al bladder training may be responsible for an increase in lower urinary tra ct dysfunction.